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Case Report
Hyperreactio luteinalis with enlargement in the postpartum period: Case report and review of the literature
1 Atrium Health Wake Forest Baptist, Department of Gynecologic Oncology, Medical Center Boulevard, Watlington 4th Floor, Winston Salem, NC 27157, USA
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Christine McGough
Medical Center Boulevard, Watlington 4th floor, Winston Salem, NC, 27157,
USA
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Article ID: 100193Z08CM2025
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McGough C, Berry L. Hyperreactio luteinalis with enlargement in the postpartum period: Case report and review of the literature. J Case Rep Images Obstet Gynecol 2024;11(1):17–21.ABSTRACT
Introduction: Hyperreactio luteinalis (HL) is a rare but recognizable cause of bilateral adnexal masses in pregnancy, with approximately 130 cases reported to date in the literature. It is often associated with virilization, elevated tumor marker levels, extreme elevation in beta hCG, molar gestation, and has been linked to preeclampsia and HELLP. While there are case reports of HL first being diagnosed in the postpartum period, it is most commonly diagnosed during the third trimester or incidentally at time of cesarean section. We present a case of HL diagnosed in pregnancy with enlargement in the postpartum period that ultimately required surgical intervention.
Case Report: A 21-year-old primigravida initially presented with bilateral adnexal masses at 18 weeks gestation, which were followed throughout her pregnancy and thought to reflect HL. She was admitted at 22 weeks with worsening abdominal pain and distention, and ultimately delivered vaginally at 23 weeks due to pre-eclampsia with severe features. She then re-presented six weeks postpartum with worsening abdominal distention and pain with masses filling the abdomen and pelvis. Ultimately due to symptoms she underwent exploratory laparotomy, drainage of adnexal masses, bilateral ovarian cystectomy, and reconstruction. Pathology was consistent with HL. She had an uncomplicated post-operative course and is recovering well.
Conclusion: Hyperreactio luteinalis is a rare diagnosis but should be on the differential for adnexal masses in pregnancy. Further study should be given to normal course of cysts without intervention and surgical or interventional radiology intervention should be considered for significant symptoms.
Keywords: Adnexal mass in pregnancy, Hyperreactio luteinalis, Postpartum
SUPPORTING INFORMATION
Author Contributions
Christine McGough - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Laurel Berry - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Christine McGough et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
